{{ 'SHOW_CART' | translate }} >

{{total | currency:"$"}}

{{::eventInfo.eventName}}

{{eventInfo.startDateUnix | localeLongDate:currentLanguage : 'LLL' : eventInfo.eventTimeZone : true}}
{{::eventInfo.where}}

{{::eventInfo.description}}

{{ 'COUPON-APPLIED' | translate }}

{{ 'INVALID-SECONDARY-COUPON' | translate }}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'FIRST-NAME' | translate}}

{{ 'REQUIRED' | translate }}

No emails or URLs allowed

{{ 'IDENT.NAME_CHARS_LONG' | translate}}

{{ 'LAST-NAME' | translate}}

{{ 'REQUIRED' | translate }}

No emails or URLs allowed

{{ 'IDENT.NAME_CHARS_LONG' | translate}}

{{ 'BIRTH-DATE' | translate}}

{{ 'IDENT.RACE_AGE_BETWEEN' | translate:regOptionAgeTranslate }}

{{ 'IDENT.SERIES_RACE_AGE_ERROR' | translate }}

{{ 'REQUIRED' | translate }}

{{'REQUIRED_DATE_FORMAT' | translate:'{format: eventInfo.displayDateFormat}' }}

{{ 'GENDER' | translate}}

{{ 'REG-OPTION-GENDER-ERROR' | translate}}

{{ 'PRIMARY-PHONE' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'NOT-VALID-PHONE-NUMBER' | translate}}

{{ 'EMAIL' | translate}}

{{ 'EMAIL-CONFIRM' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'SAME-EMAIL' | translate}}

{{ 'PARTICIPANT-CONDITION' | translate}}

{{ 'ADDRESS' | translate }}

{{ 'COUNTRY' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STREET' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STREET_2' | translate}}

{{ 'POSTAL-CODE' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}} {{ 'VALID-ZIP' | translate}}

{{ 'CITY' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'STATE/REGION' | translate}}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'EMERGENCY-CONTACT' | translate }}

{{ 'EMERGENCY-CONTACT' | translate}}

{{ 'REQUIRED' | translate }}

{{ 'RELATIONSHIP' | translate}}

{{ 'PHONE' | translate}}

{{ 'PROVIDE-VALUE' | translate}}

{{ 'NOT-VALID-PHONE-NUMBER' | translate}}

{{ 'CONTACT-CANNOT-BE-EVENT-P' | translate}}

{{ 'DATA-PRIVACY' | translate}}

{{ 'EMAILS-REGARDING-REG-NO-PARAM' | translate}}

{{ eventInfo.marketingConsentQuestionText}}

{{eventInfo.marketingEmailQuestionText}}

The Kathleen M. Rotz Lung Cancer Research Fund  3rd Annual 5K Run/Walk   
 Accident waiver and release of liability: Release of name and likeness   I know that running/walking a race is a potentially hazardous activity. I certify that I am physically fit have sufficiently trained and prepared for participation in the event and have not been advised otherwise by a qualified medical person. I agree to abide by any decision of a race official relative to my ability to safely complete the run. I hereby consent to receive medical attention which may be deemed advisable in the event of an injury, accident and/or illness during this event. I understand that all evacuation and medical costs for participants and volunteers will be borne by that person or their heirs. The race organizers and sponsors are in no way liable or responsible for medical costs or emergency evacuation.   The race directors have addressed all safety issues on the paved and dirt/hard pack and loose gravel race course trails areas. I assume all risks associated with running in the event, including, but not limited to, falls, contact with other participants, volunteers, race officials, sponsors, walkers, baby strollers or "baby- joggers", in‐line skating, dogs on leashes, bicycles, the effects of the weather, including high heat and/or humidity, traffic and the conditions of the road, all such risks being known and appreciated by me.   Having read this waiver and knowing these facts, and in consideration of your accepting my entry, I hereby take action for myself, my heirs, executors, next of kin, administrators or anyone else who might claim on my behalf, waive and release, The Following Entities or Persons: The Kathleen M. Rotz Lung Cancer Research Fund, all involved municipalities or public entities (and their respective agents and employees) the event holders, the event sponsors (and their directors, officers, volunteers, representatives and agents), Lin-Mark Computer Sports, Inc., event volunteers and event directors, from all claims or liability for death, personal injury, or property damage of any kind or nature whatsoever arising out of, or in the course of, my participating in this event whether same be caused by negligence or fault. This release and waiver extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown and I indemnify and hold harmless the entities or persons mentioned in this paragraph from any or all liabilities or claims made by any other individual or entities as a result of my actions during this event.

{{ 'MUST-AGREE' | translate}}

{{ !gigyaLoaded() ? 'GET-ATHLETE-UPDATE-MOBILE' : 'GET-ATHLETE-UPDATE' | translate}}

{{ !gigyaLoaded() ? 'MOBILE-DELIVER' : 'FACEBOOK-DELIVER' | translate}}

{{ 'COUPON-APPLIED' | translate }}

{{ 'INVALID-COUPON' | translate }}

{{ 'PLEASE-PROVIDE-VALUE' | translate}}

{{ 'ITEM-FREE' | translate }} * {{ 'MAKE-SELECTION' | translate }}
  • {{ 'VIEW-IMAGES' | translate }}

{{ entry.storefront.products[product.id].price | currency:"": currency.decimal }}

{{ 'FREE' | translate }}

{{ product.name }}

{{ product.description }}

* {{ 'SHIPMENT-ONLY' | translate }}

* {{ 'EVENT-PICKUP-ONLY' | translate }}

SKU# {{product.sku}}
{{ 'ONLY' | translate }} ({{getProductOptionRemainingQty(option, product.id, entries, true)}}) {{ 'IN-STOCK' | translate }}
{{ 'ITEM-FREE' | translate }} * {{ 'MAKE-SELECTION' | translate }}
  • {{ 'VIEW-IMAGES' | translate }}

{{ entry.storefront.products[product.id].price | currency:"": currency.decimal }}

{{ 'FREE' | translate }}

{{ product.name }}

{{ product.description }}

* {{ 'SHIPMENT-ONLY' | translate }}

* {{ 'EVENT-PICKUP-ONLY' | translate }}

SKU# {{product.sku}}
{{ 'ONLY' | translate }} ({{getProductOptionRemainingQty(option, product.id, entries, true)}}) {{ 'IN-STOCK' | translate }}


{{ 'PAYMENT-ERROR' | translate}}

{{paymentErrors.message}}

  • {{error}}
  • {{errValue}}

{{ 'CORRECT_ERRORS_FOR_ENTRY' | translate }}

{{ 'COMPLETE_REGISTRATION_FOR_ENTRIES' | translate}}

{{entry.name | translateIf:entry.translate}}

{{ 'EDIT' | translate }} (errors)

{{item.name | translateIf:item.translate}} :

{{item.price | currency:"$":currency.decimal}}
Remove
{{ 'SUBTOTAL' | translate}} : {{cart.subtotal | currency:"$":currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$":currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.fee | currency:"$":currency.decimal}}
{{ 'SALES_FEE' | translate}} : {{cart.totalSales | currency:"$":currency.decimal}}
{{!cart.hasLottery ? ('TOTAL'|translate) : ('TOTAL_CHARGE_AT_CHECKOUT'|translate)}} : {{cart.total | currency:"$": currency.decimal}}

{{item.name | translateIf:item.translate}} :

{{item.price | currency:"$":currency.decimal}}
Remove
{{ 'SUBTOTAL' | translate}} : {{cart.subtotalLottery | currency:"$": currency.decimal}}
{{customFee.description}} : {{customFee.price | currency:"$": currency.decimal}}
{{ 'PROCESSING_FEE' | translate }} : {{cart.lotteryFee | currency:"$":currency.decimal}}
{{ 'TOTAL_CHARGE_IF_SELECTED' | translate}} : {{cart.lotteryTotal | currency:"$": currency.decimal}}
{{ 'IF_SELECTED_CHECKOUT' | translate:cart}}

{{ 'PAYMENT-ERROR' | translate}}

{{paymentErrors.message}}

  • {{error}}
  • {{errValue}}
{{ 'NO-PAYMENT-REQUIRED' | translate }}
{{ 'MASTERPASS-TAGLINE' | translate }}

{{ 'MASTERPASS-HEADLINE' | translate }}

{{ 'MASTERPASS-DESCRIPTION' | translate }}


{{ 'OR' | translate }}

{{ 'NAME-ON-CARD' | translate }}

{{ 'REQUIRED' | translate }} {{ 'PAYMENT-NAME-MIN-LENGTH' | translate }}

{{ 'CARD-NUMBER' | translate }}
{{ 'EXPIRATION' | translate }}
{{ 'SECURITY-CODE' | translate }}
{{ 'POSTAL-CODE' | translate }}
{{ 'CARD-NUMBER' | translate }}
{{ 'EXPIRATION' | translate }}
{{ 'SECURITY-CODE' | translate }}
{{ 'POSTAL-CODE' | translate }}

{{ 'REQUIRED' | translate }}

{{'SHIPPING-ADDRESS' | translate}}


{{ 'FIRST-NAME' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'LAST-NAME' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'COUNTRY' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'POSTAL-CODE' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'STREET' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'CITY' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'EMAIL' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'ENTER_VALID_EMAIL' | translate }}

{{ 'REGION' | translate }}

{{ 'REQUIRED' | translate }}


{{ 'PAYMENT-INFORMATION' | translate }}


{{ 'NAME-ON-CARD' | translate }}

{{ 'REQUIRED' | translate }} {{ 'PAYMENT-NAME-MIN-LENGTH' | translate }}

{{ 'CARD-NUMBER' | translate }}

{{ 'REQUIRED' | translate }} {{ 'INVALID-CREDIT-CARD-NUMBER' | translate }}

{{ 'EXPIRATION' | translate }}

{{ 'REQUIRED' | translate }} {{ 'INVALID-EXPIRATION-DATE' | translate }}

{{ 'SECURITY-CODE' | translate }} (CSC/CVC/CVV)

{{ 'REQUIRED' | translate }} {{ 'INVALID-SECURITY-CODE' | translate }}

{{ 'REQUIRED' | translate }}

{{ 'PAYMENT-INFORMATION-MESSAGE' | translate }}


Get your friends to join you
Have {{entryReferralData.goal}} friends sign up using the link below to receive {{entryReferralData.award | currency:"$"}}
Share to Facebook Copy Referral Link

{{crowdriseTeam.entryName}} Charity Event Fundraising on Crowdrise

{{crowdriseTeam.entryName}}: {{crowdriseTeam.msg}} (Crowdrise error)

The internet browser you are using to access this registration form is not supported. Please upgrade your browser or register on your mobile device.
Scan this QR Code with your mobile device to load the mobile registration form.
Event registration link